Audit evaluating the management of endocrine health in survivors of adult-onset hormone-sensitive cancers (#81)
Hari Haran R
1
,
Anna Kuchel
2
,
Elizabeth Wooton
1
- Department of Endocrinology and Metabolic Medicine, Royal Brisbane And Women's Hospital, Brisbane, Queensland, Australia
- Medical Oncology, Cancer Care Service, Royal Brisbane And Women's Hospital, Brisbane, Queensland, Australia
Background
Patients with breast and prostate cancer often undertake years of hormone-suppressive therapy. While effective in disease control, hormone suppressive therapy can lead to long-term endocrine health-related complications such as osteoporosis, metabolic syndrome and reduced quality of life due to hypogonadal symptoms such as hot flushes and sexual dysfunction. The population of survivors of these cancers is growing, with endocrine health being important but often under-recognized with substantial implications for ongoing morbidity and mortality.
Objectives
To audit local practices on screening, monitoring and management of endocrine health-related issues in survivors of early breast cancer and metastatic prostate cancer receiving hormone suppressive therapy.
Methods
A retrospective review of 50 patients with metastatic prostate cancer and 50 patients with early breast cancer who commenced hormone suppressive therapy between 2020-2021 at the Royal Brisbane and Women’s Hospital was conducted. Electronic medical records were reviewed. The authors selected relevant audit standards from national and international guidelines.
Results
Preliminary findings suggest that a significant proportion of cancer survivors experience therapy-related osteoporosis, metabolic syndrome and hypogonadal symptoms, with a considerable impact on their quality of life. Clinicians, in most cases, screen for metabolic syndrome and osteoporosis before commencing hormonal therapy. However, annual monitoring is not routinely done. Symptoms associated with hypogonadism (vasomotor symptoms and sexual dysfunction) are the most under-recognised and undertreated. A deeper analysis of the data is awaited.
Conclusion
This audit reveals a substantial burden of endocrine dysfunction among survivors of hormone-sensitive cancers and highlights the need to improve local practices. Strong collaboration is warranted between general practitioners, endocrinologists, oncologists, nurses, and the allied health team. We intend to implement strategies to raise awareness of the issue and current best practices by presenting our results at local and national meetings.